The Centers for Medicare & Medicaid Services (CMS) has launched the WISeR Model (Wasteful and Inappropriate Service Reduction) to modernize and streamline Medicare’s prior authorization process. By partnering with tech companies, CMS will test the use of modern tools, such as artificial intelligence, to reduce unnecessary or low-value services that drive up costs and pose
DOJ Announces Largest Health Care Fraud Takedown in U.S. History
In the largest health care fraud takedown in U.S. history, the Justice Department announced charges against 324 individuals—including 96 licensed medical professionals—in connection with schemes involving over $14.6 billion in intended losses across 50 federal districts and 12 State Attorneys General Offices. The coordinated enforcement action led to the seizure of more than $245 million
Oregon Legislature Passes Nation’s Strictest Restrictions on the Corporate Practice of Medicine
Oregon is on the verge of passing a bill that would block private-equity ownership in healthcare practices. If passed, this measure would be the strictest ban on the corporate practice of medicine in the nation (read press release here). The bill would prohibit Management Services Organizations (MSOs) and their affiliates from owning or controlling
Oracle, Cleveland Clinic, and G42 Announce Strategic Partnership to Launch AI-Based Global Healthcare Delivery Platform
In attempt to deliver more effective and affordable care, Oracle, Cleveland Clinic, and G42 have announced a strategic partnership that will build a global AI-powered healthcare platform (see news release here).
Per the news release published by Cleveland Clinic, the platform will: (i) deliver an AI-driven healthcare infrastructure rooted in data privacy, clinical quality
Virtual Healthcare Law Presentation: Understanding Restrictive Covenants and Key Contract Terms
On Thursday, May 22, from 6:00 – 7:00 PM, attorneys Michael Cassidy and Adam Appleberry will present a virtual program focused on the legal framework surrounding restrictive covenants in healthcare employment contracts.
The presentation will cover recent developments in the law, including the Fair Contracting for Health Care Practitioners Act, and other regulatory changes that
2025 Medicare Final Rule Highlights
Attorneys Mike Cassidy and Adam Appleberry co-authored an insightful article, 2025 Medicare Final Rule Highlights, featured in the December 2024 issue of the Allegheny County Medical Society (ACMS) Bulletin. The article explores the key updates to Medicare regulations and their implications for healthcare providers.
Click here to access the ACMS Bulletin to read
Federal and Pennsylvania Corporate Reporting Requirements: Subject to Nationwide Injunction
This is a last in a series of client alerts and blog posts we’ve issued over the last year designed to inform you of the new Federal and Pennsylvania corporate reporting obligations.
ALERT: The U.S. District Court E.D. Texas has issued a nationwide preliminary injunction against enforcement of the reporting rules below.
Federal
The financial
Medicare Telehealth Reimbursement Update
Our Introduction to Telehealth, Technology and Federal Enforcement chapter was published in the Thomson Reuters 2025 Health Law Handbook. It reviewed a number of telehealth Medicare revisions, both permanent and temporary, enacted by a series of consolidated appropriation acts and physician fee schedule amendments arising out of the 2020 COVID pandemic.
The temporary telehealth
Medicare Decreases Physician Fee Schedule by 2.93%
The final Medicare Physician Fee Schedule was issued on November 1st for calendar year 2025. Attached is a link to both the Press Release describing all of the Medicare changes and the link to the entire Final Rule.
The Medicare Conversion Factor for the Physician Fee Schedule was decreased from $33.29 from 2024
Telehealth News
Mike Cassidy and Adam Appleberry have had a chapter published in the Thomson Reuters Health Law Handbook: “Introduction to Telehealth, Technology, and Federal Enforcement”.